Self-employed RNs are accountable to all nursing legislation and standards. The College does not recommend self-employed practice by new graduates or RNs with limited or no recent registered nursing practice.
Self-employed RNs must:
- Be registered on the College’s practicing register
- Meet the College’s annual continuing competence program (CCP) requirements
- Be able to provide verification of RN practice hours by an independent third party such as an accountant, lawyer, tax specialist or designated person in authority (cannot be a family member)
- Have and maintain competencies in the area in which registered nursing services are being provided
- Demonstrate the use of the nursing process to assess, make diagnoses, plan, implement and evaluate all care in a holistic manner
Assessment of Nursing Practice
Registered nurses who are considering engaging in self-employed practice must ensure that the services they plan to provide fall within the scope of registered nursing practice. If your practice is not direct care (such as consulting work) think about who your clients are and how you bring a nursing lens to your practice. If you are unsure if the services you are providing are RN or RN(NP) practice in Manitoba, you can contact a practice and standards consultant at firstname.lastname@example.org or 204-774-3477 ext. 301 or you can complete and submit the appropriate assessment of nursing practice form below:
- Assessment of Self-employed Registered Nursing Practice Form (Word document)
- Assessment of Self-employed RN(NP) Practice Form (Word document)
Submit your completed form to:
Practice and Standards Consultant
College of Registered Nurses of Manitoba
890 Pembina Hwy
Winnipeg, MB R3M 2M8
College staff will review the assessment of nursing practice and inform you of the decision within two weeks. Please note that in exceptional circumstances the review process may be longer.
Can I use "certification" in my designation?
In order to present an accurate image to the public, it's important we understand what "certification" means. Being certified in an area of practice means that several criteria are in place, including:
- a national or international board or association who oversees the certification program,
- national or international competencies the board or association identifies the applicant must demonstrate,
- formal demonstrations of the competencies (e.g. taking an exam), and
- maintaining competence through formal methods (e.g. re-examination or developing a portfolio every few years).
Without these criteria, RNs must not use the term "certified" in education designations (e.g. certified foot care nurse or CFCN). Of course, in this example, it is still acceptable to describe your role as "foot care nurse".
Scope of Practice
Accrual of registered nursing practice hours is a requirement for registration renewal. The service being provided by self-employed registered nurses must meet the definition of registered nursing practice in The Registered Nurses Act (2001) section 2(1). The approved assessment of nursing practice ensures you can accrue nursing practice hours.
The management of information is an important aspect of self-employed practice. You must keep a client record for at least 10 years following the date of the last entry on the record. You must keep a client record of a minor for at least 10 years after the minor turns 18.
If you go into facilities to provide direct care (e.g. foot care) you will need to think about how you will document:
- Do you have permission from the client and facility to access a client’s existing health-care record? Remember, the facility is the custodian of that record.
- Does the facility know you are there? How will you notify them?
- What are their policies regarding those providing private care for clients in their care?
- Have you signed a confidentiality form?
- If you document on the client file, how do you maintain records for your own practice? What are your options?
Manitoba Health, Healthy Living and Seniors (MHHLS) has developed three PHIA online training programs primarily for private practitioners and their staff. Click here to access the training versions. MHHLS has also developed a list of the policies and procedures required by trustees, including health professionals in private practice, to comply with PHIA. Click here to view these resources on the MHHLS website.
Self-employed RNs have a legal and ethical responsibility to obtain informed consent from clients for any registered nursing services.
Self-Employed Practice Review
Each year after registration renewal, the College reviews the members who have identified as self-employed. There is more responsibility related to being self-employed as there are often no colleagues or managers to consult or monitor your practice. We do ask for a periodic assessment of nursing practice usually every five years or when your practice has changed significantly. We will also ask for a verification of hours so it is important to keep track of these hours and determine a process to verify them.
If you are considering self-employed registered nursing practice you should consult with business professionals such as lawyers and accountants. The College does not provide legal advice.
For information regarding liability protection:
Canadian Nurses Protective Society (CNPS)
Marketing strategies such as business cards, brochures and media advertising may be used provided that the service is represented clearly. It is recommended that legal and financial advice be sought regarding registering the name of the business, licensing requirements, etc.
Governments do not reimburse RNs through provincial health insurance plans, therefore most self-employed RNs are paid directly by their clients or their private insurance. Seeking the advice of an accountant or other financial consultant(s) is recommended.
- The Registered Nurses Act and Regulations
- Standards of Practice for RNs
- Standards of Practice for RNs on the Extended Practice Register
- Entry Level Competencies for RNs
- Competencies for NPs in Manitoba
- Professional Boundaries for Therapeutic Relationships
- Is my practice registered nursing practice?
- Calculating Practice Hours for Registration Renewal
- Regulated Professional Titles
- CCP Requirements
Canadian Nurses Protective Society (CNPS)
- Legal Risks of Email: Part I
- Legal Risks of Email: Part II
- Collaborative Practice: are nurses employees or self-employed?
- Vicarious Liability
- CMPA/CNPS Joint Statement on Liability for NPs and Physicians in Collaborative Practice
Canadian Nurses Association (CNA)